THE SCURVY.
It has been supposed by many that Hippocrates described scurvy under the name of enlarged spleen, an affection attributed to the use of stagnant water and characterized by tumefaction of the gums, foul breath, pale face, and ulceration of the lower limbs. But the study of this Hippocratic passage leads us to think that these symptoms were more of the character of scrofula than of scurvy. The recital by Pliny of the diseases of the Roman soldiers while on an expedition to Germany seems to indicate scurvy, which Coelius Aurelianus, and after him the Arabian physicians, claims presented only a slight analogy to that affection.
Springer thinks that we may find the first traces of scurvy in the expedition of the Normans to Wineland, in the first years of the eleventh century. In admitting that the men commanded by Eric Thorstein were obliged to winter on the western shores of Wineland and almost all succumbed to an endemic malady of that country, proves that it was nothing but scurvy, although that word’s only signification, in Danish, is ulceration of the mouth.
We have, besides, another document, which has great authentic value, a proof transmitted to us by our earliest and best chronicler of the Middle Ages, by Joinville, the friend and companion of Saint Louis in his Crusade into Palestine. In his memoirs he gives a very succinct recital of the epidemic of famine and scurvy which attacked the French army on the banks of the Nile in 1248, just after the battles of Mansourah. Says Joinville: “After the two battles just mentioned, commenced our great miseries in the army; at the end of nine days the bodies of our dead soldiers arose to the surface of the water (their tissues were corrupted and rotten), and these corpses floated to a point between our two camps (those of the King and the Duke of Bourgogne), at a point where a bridge touched the water. So many had been slain that a great crowd of corpses floated on the stream for a long distance. The bodies of the dead Saracens were sickening; the army servants threw open a portion of the bridge and permitted the dead infidels to float down the river, but they buried the dead Crusaders in great pits dug in the ground. I saw among other dead the body of the Chamberlain of the Count D’Artois, and many other friends among the slain.
“The only fish we had eaten for four months were of the variety called barbus, and these barbus fed on the dead bodies, and for this cause and other miseries of the country where never a drop of rain fell sickness entered our army of such a sort that the flesh on the limbs dried and the skin on the legs became black and like old leather boots, and many sick rotted in their groin; and all having the last named symptom died. Another sign of death was when the nose bled.”
The relation of Joinville leaves no doubt as to the nature of the epidemic that attacked the Crusaders. Here we have a pen picture of the debility, the hemorrhages, the livid ecchymosis of the skin, the fungous tumefaction and bleeding of the gums, which characterize the disease known as scurvy.
According to the writings of some German physicians of the fifteenth century, this malady was endemic in the septentrional portions of Europe upon the shores of the Baltic Sea. In Holland numerous epidemics of scurvy were observed among the lower classes of the population, coinciding with bad conditions of public hygiene. Food consisting of salt and smoked meats, dwellings located on marshy ground, cold atmospheres charged with fogs, etc., etc.
This was the same affection that attacked our colonies in Canada, but at that time we had no knowledge of the therapeutic indications in such emergencies, and quote as a proof of this a remarkable observation inscribed on the registers of Cartier on his vessels during his sojourn in Canada: “The disease commenced in our midst in a curious and unknown manner; some patients lost their flesh and their limbs grew black and swollen like charcoal, and some were covered over with bloody splotches like purpura; after which the disease showed itself on the hips, thighs, arms, and neck, and in all the mouth was infected and rotten at the gums, so that all the flesh fell off to the roots of the teeth, which also most often dropped out; and so terrible was this plague that on my three ships by February only ten healthy men were about out of a crew of over a hundred.
“And, as the disease was unknown to us, the Captain of the ships was asked to open a few bodies to see if we could possibly detect the lesion and thus be able to protect the survivors. We found the hearts of the dead to be white and withered, surrounded by a rose colored effusion; the liver healthy, but the lung black and mortified and all its blood retired to the sac of the heart. The spleen likewise was impaired for about two finger-lengths as though rubbed by a rough stone.”
From this autopsy rudely made[26] it is true we discern most of the signs of scrofula; a profound alteration of the blood and an effusion of the liquids into certain viscera, denoting a diminution in the amount of fibrin and the number of globules, alterations that also serve to explain the tendency to hemorrhages observed in very serious cases of scurvy.